Exercise as it relates to Disease/Lifestyle or exercise physical activity, which is better for fitness and health?

What is the background to this research?
There has been a strong decrease in the amount of physical activity levels in Australian adults, with increasing sedentary behavior. 60% of the population is currently being reported to being either inadequately active or completely inactive. These Sedentary habits account for a substantial increase the risk factors of developing many serious medical conditions including; coronary heart disease, type 2 diabetes, cancer, hypertension, hyperglycemia and metabolic syndrome.

An increase in Physical activity levels has been demonstrated to reduce the incidence of type 2 diabetes by more than half in persons. An increase in physical activity and cardiorespiratory fitness is consistently associated with the reduced risk of many health outcomes including, cardiovascular disease, the metabolic syndrome, type 2 diabetes and many forms of cancers The links between reported physical activity levels, sedentary life style behaviours and their associated medical conditions has prompted a 24-month intervention. This study compares the effects of a lifestyle physical activity program against traditional structured exercise, to determine how best to improve physical activity, cardiorespiratory fitness, and cardiovascular disease risk factors.

Where is the research from?
The journal of American medical association Andrea L. Dunn, PhD; Bess H. Marcus, PhD; James B. Kampert, PhD; Melissa E. Garcia, MPH; Harold W. Kohl III, PhD; Steven N. Blair, PED

What kind of research was this?
Randomised clinical trial

What did the research involve?
116 Sedentary men and 119 women with self-reported physical activity of less than 36 and 34 kcal/kg per day, were selected to participate in a 24 month physical life style intervention. The intervention consisted of 6 months of an intensive training on either a traditional exercise program, or an altered life style physical activity plan. Both would be followed up by an 18-month maintenance plan.

The out comes that were to be tested and assessed included physical activity assessed by the 7-Day Physical Activity Recall and peak oxygen consumption by a maximal exercise treadmill test. As well as plasma lipid and lipoprotein cholesterol concentrations, blood pressure, and body composition. Each of these tests was conducted prior to the commencement of the intervention, in order to attain a base line, along with testing at 6 and 24-month periods.

What were the basic results?
Both the traditional exercise training group and the life style groups demonstrated improvements in cardiorespiratory fitness from baseline to 24 months. Both groups were able to show significant decreases in systolic and diastolic blood pressure. Although neither group were able to make significant a reduction to body weight, they did significantly reduce their body fat percentages. There was no significant difference between the two groups at the completion of the 24-month protocol.

How did the researchers interpret the results?
The researches interpreted the both interventions as having a positive relationship in increases in physical activity, cardiorespiratory fitness, blood pressure, and percentage of body fat at the end of the intervention in comparison to their baseline results. In these outcomes there were shown to be no significant differences between the lifestyle and structured exercise groups at the conclusion of the intervention.

There were however significant differences at the 6month test with nearly a two times fitness increase towards the traditional exercise over the life style protocol. When the tests were completed again at the 18-month mark, the fitness levels were approaching parity, before reaching a similar level by the 24-month mark.

What conclusions should be taken away from this research?
The effects of physical inactivity and a sedentary life style can be corrected for the better using either a traditional exercise program, or through a change in lifestyle habits aimed at increasing activity levels throughout the day. Both protocols were able to demonstrate significant increases in fitness levels over a prolonged period, however it did demonstrate the traditional exercise program to be more effective over the short term for maximal results. Previous studies may have supported the findings that an increase in physical activity has on increasing cardiorespiratory fitness and reducing body fat. These changes reduce the risk factors of developing for disorders such as metabolic syndrome and as such these interventions should be encouraged.

What are the implications of this research?
This study will enable medical practitioners further protocols when trying to reduce the risk factors for individuals in danger of developing metabolic syndrome, and many of its associated diseases. This is crucial as many elderly or disabled individuals may not be able to conduct a traditional exercise program.